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To the Editor: We describe a case of coarctation of the aorta associated with exposure to etanercept during pregnancy. Our female patient was 27 years of age when she developed rapid onset of inflammatory polyarthritis in a symmetrical pattern, with a positive rheumatoid factor and erosions on hand and wrist radiographs. She was diagnosed with rheumatoid arthritis (RA). She was treated with serial disease-modifying antirheumatic drugs including hydroxychloroquine, methotrexate, leflunomide, and intermittent prednisone. Her arthritis was under control when she had a planned pregnancy in 2003, at the age of 31. She continued taking prednisone and hydroxychloroquine throughout this first pregnancy. She gave birth to a healthy girl at 35 weeks of gestation. In her postpartum period, she had persistent exacerbation of her RA. At 12 weeks’ postpartum, she started etanercept 25 mg subcutaneously (SC) twice weekly. Her joint inflammation improved significantly with etanercept, and over 1 year her prednisone was slowly tapered … Address correspondence to Dr. Shojania. E-mail: kam.shojania{at}vch.ca.

Coarctation of the Aorta in an Infant Exposed to Etanercept in Utero